One Spring morning, I suddenly found myself in the emergency room hooked up to an EEG monitor and with an IV in my arm. I was experiencing severe heart palpitations plus feeling extremely dizzy and had gone to the ER, afraid I was having a heart attack at 27 years old. The diagnosis? In short, start-up entrepreneurship.

At the time, I didn't share this ordeal with anyone. I felt like it was a sign of failure, that I simply couldn't keep up with my hectic entrepreneurial life and couldn't manage the anxiety that came with making payroll, advocating for a new way of solving problems, and wearing the hats of accountant, salesperson, product delivery manager, and marketer. I assumed I was alone in experiencing this type of health scare.

Almost two decades later, now a Professor of Entrepreneurship at a leading U.S. Business school, I listened to my co-instructor introduce himself to our students by sharing the details of an eerily similar event that had happened to him with his first successful (then not successful, then successful again) start-up.

And we're not alone. Health issues are surprisingly common among entrepreneurs who find themselves struggling with exhaustion, stress-related illness, depression, substance abuse and everything in between. Entrepreneurs have begun speaking out about their internal struggles in an attempt to combat the stigma of depression and anxiety that makes it difficult to make room for healing. In advance of their success, they grappled with seemingly crippling depression or anxiety.

Ann Yang, cofounder of Misfit Foods, a company that turns ugly produce into delicious food and fights climate change in the process, made the tough decision to leave her company and focus on her depression. "My life as an entrepreneur had not left space for me to think seriously about my mental health," she says. "In retrospect, both my brain and my body were telling me that what I was doing was unsustainable, and I tried to ignore it for a long time."

What's going on here? Part of the problem is that there are challenges the come with the nature of being an entrepreneur. Generally, entrepreneurs are chronically sleep-deprived, more competitive than most, and feel a responsibility to their investors, employees and business partners. Also, your business has a 30 percent chance of failing before its third birthday and a 70 percent likelihood of failing before it its tenth birthday. 

Some entrepreneurs are subject to these chemical and biological issues. Clinical psychiatrist Dr. Michael A. Freeman set out to determine if there was truly a psychological difference between entrepreneurs and non-entrepreneurs. The statistics support the anecdotes. The study he led revealed that depression is two times higher in entrepreneurs versus non-entrepreneurs. While ADHD is almost six times higher, substance abuse is three times higher, and bipolar disorder is eleven times higher.

"People who are on the energetic, motivated, and creative side are both more likely to be entrepreneurial and more likely to have strong emotional states," says Freeman. "Those states may include depression, despair, hopelessness, worthlessness, loss of motivation, and suicidal thinking." The same intense characteristics that motivate founders can also be detrimental.

Jessica Carson, the Director of Innovation at a major mental health organization, and Expert-in-Residence at Georgetown University's Entrepreneurship Initiative, says that this data "actually reflects an incredible and invaluable strength in the entrepreneur -- without this wiring that is predisposed to extremes, they would not be all of the things that  we celebrate them for." She studies entrepreneurs and high-IQ individuals and finds that ultimately these particular psychological profiles allow them to excel, but only if they are aware of their unique wiring and are able to harness it successfully.

Here are a few ways help yourself combat burnout:

1. Do what only you can do.  

One piece of advice I give to newly launched entrepreneurs is to hire an admin person and bookkeeper because most entrepreneurs feel depleted by the tasks that these employees would cover since they are not their natural strengths. Plus, they are time-consuming and can easily be done by someone else with little onboarding.

2. Find your tribe.  

Surround yourself with other supportive entrepreneurs. Find like-minded colleagues who are vulnerable about their challenges and dark times; don't settle for those who put on a fake brave face and never admit insecurities. Peter Mellen, founder of Netcito, a company that forms advisory groups for entrepreneurs, says his members are hungry for "trusted space where entrepreneurs can share the toughest challenges of being an entrepreneur, connect with peers and focus on strategic issues to gain insights that can be transformational impact on their businesses and lives." 

If you've been working from home, join a co-working space. The second Global Coworking Survey found that 70 percent of members felt healthier than in a traditional office setting.

3. Get out of the office.

According to the World Health Organization, "Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

  • Feeling of energy depletion or exhaustion

  • Increased mental distance from on'e job or feelings of negativism or cynacism related to one's job

  • Reduced professional efficacy.

It's not just about putting in more hours because we are less productive when we work more hours. If you work 60 hours per week, you are only 2/3rds as productive as you are when you work only 40 hours a week, so you may as well take breaks for your mind and your body. Successful entrepreneurs suggest getting outside, running, or meditating to keep anxiety low.

Most importantly, remember that you are not alone. This is not an issue that you can just "work" your way through. In fact, it requires the opposite approach.